From the Guidelines
The management of a low-grade ankle sprain in a 12-year-old girl who rolled her ankle 7 days ago, with a small joint effusion, thickened and hypoechoic ATFL, and low-grade injury, should focus on functional treatment with early weight-bearing, exercise, and functional support, as this approach has been shown to lead to faster resumption of daily activities and sports, and reduce the risk of recurrent injuries and functional ankle instability 1.
Initial Management
The initial management of the ankle sprain should include the RICE protocol: Rest, Ice, Compression, and Elevation, for the first 24-48 hours, to reduce pain and swelling. Pain can be managed with over-the-counter medications like acetaminophen or NSAIDs, as needed.
Exercise and Rehabilitation
After the acute phase (48-72 hours), gentle range-of-motion exercises should begin to prevent stiffness, followed by progressive strengthening exercises like ankle circles, alphabet tracing, and towel scrunches. Weight-bearing should increase gradually as tolerated. A simple ankle brace or athletic tape may provide support during recovery.
Prognostic Factors
It is essential to consider prognostic factors that may influence recovery, such as pain, workload, and level of sports participation, and address them early in the treatment process to prevent slow or incomplete rehabilitation and reduce the risk of future injury recurrence 1.
Return to Sports
Returning to sports should wait until full pain-free range of motion and strength are restored, which is usually within 2-3 weeks for low-grade sprains.
Key Recommendations
- Functional treatment with early weight-bearing and exercise is the preferred approach for managing low-grade ankle sprains 1.
- Pain management with over-the-counter medications, as needed, and RICE protocol for the first 24-48 hours.
- Gradual increase in weight-bearing and progressive strengthening exercises to prevent stiffness and promote recovery.
- Consideration of prognostic factors, such as pain, workload, and level of sports participation, to prevent slow or incomplete rehabilitation and reduce the risk of future injury recurrence 1.
From the Research
Management Plan for Low-Grade Ankle Injury
The management plan for a low-grade ankle injury, specifically a ligament sprain, involves several key components:
- Accurate diagnosis to determine the severity of the injury 2
- Early use of RICE (rest, ice, compression, and elevation) therapy to reduce pain and swelling 2, 3
- Maintenance of range of motion to prevent stiffness and promote healing 2
- Use of an ankle support to provide stability and protection 2
- Early ambulation and rehabilitation to promote recovery and prevent chronic instability 4, 5
Treatment Options
Treatment options for low-grade ankle injuries may include:
- Manual therapy to promote healing and reduce pain 4
- Cryotherapy to reduce pain and inflammation 4
- Functional supports to provide stability and protection 4
- Short-term NSAIDs to reduce pain and inflammation 4
- Rehabilitation exercises to promote recovery and prevent recurrent injuries 5, 6
Prevention of Recurrent Injuries
Prevention of recurrent injuries is also an important aspect of management: